The patient came to the clinic 09-April-2014 complaining of numbness both hands for 7 years. The last 2 months got neck and both shoulders pain more the left, with dyseasthesia left hand. MRI  cervical spine done 19-February-2014 showing OPLL with severe stenosis at C5-6 with malacia of the spinal cord. X-ray cervical spine done the same day showing retrolisthesis C5-6. The patient is a known hypertensive for 12 years.

On examination; the patient is using hearing devices both sides for more than 10 years. There is pain when turning the head to both sides, up and bending the head to the left shoulder. There is weak extension left hand -4/5, left triceps 3/5 and hypalgesia radial side of the left forearm and median nerve territory.

Discectomy C5-6 was done with C-arm guidance. Total discectomy was achieved with osteophytectomy. The dura was seen at the left posterior 2/3. Using Vitatech Aspen SE cervical cage 16x7.5x13 mm with lordosis 5 degrees was inserted to the disc space and secured. Hydr'Os Bone graft 1 ml was used. Routine closure of the wound

Smooth postoperative recovery. The power of the left upper limb became normal.

The patient has spondylolisthesis C5-6 which take precedence in his situation. This must be corrected first.

ASPEN SE has the advantage to put the cage without using plate and screws. It provide this function with the built in metallic device, that hold the device in place without any motion. This idea is accepted to one level surgery in old age patients.